Matthew V. Kiang, Sc.D., from the Stanford University School of Medicine in California, and colleagues conducted a cross-sectional study to identify changes in the geographic distribution of opioid-related mortality across the United States. Individual-level data were included for 351,564 U.S. residents who died of opioid-related causes from Jan. 1, 1999, to Dec. 31, 2016.

The researchers found that the mean age of death was 39.8 and 43.5 years for men and women, respectively. In all of the eastern United States, opioid-related mortality rates increased rapidly, especially from synthetic opioids. Mortality associated with natural and semisynthetic opioids remained stable in most states. In 28 states, mortality rates from synthetic opioids more than doubled every two years, including 12 with high mortality rates from synthetic opioids (>10 per 100,000 people). In these 28 states, there was variation in the mortality rate from natural and semisynthetic opioids from 2 to 18.7 per 100,000 people. The fastest rate of increase in mortality from opioids was seen in the District of Columbia.

“Our findings indicate that policies focused on reducing opioid-related deaths may need to prioritize synthetic opioids and rapidly expanding epidemics in northeastern states and consider the potential for synthetic opioid epidemics outside of the heroin supply,” the authors write.